Hiccups. Attitude in Otorhinolaryngology Towards Consulting Patients. A Diagnostic and Therapeutic Approach
Por:
García Callejo FJ, Redondo Martínez J, Pérez Carbonell T, Monzó Gandía R, Martínez Beneyto MP and Rincón Piedrahita I
Publicada:
1 mar 2017
Ahead of Print:
16 ago 2016
Categoría:
Otorhinolaryngology
Resumen:
Introduction: Hiccup crises are generally benign and self-limiting, but longer episodes affect quality of life and must be treated. There are recognisable causes that otorhinolaryngologists must know and be aware for diagnosis and therapeutic alternatives. The main expression is a spasmodic glottic noise with characteristic neck alterations.
Patients and methods: This was a retrospective study from 1979 with patients suffering persistent or recurrent hiccups. Chronobiology, comorbidity, findings from explorations, therapies and outcomes were noted. Thirty-seven patients were studied (mean age, 45.5 +/- 13.5 years; 30 males), with persistent hiccups in 23 (62%).
Results: A potential associated aetiology was observed in 24 cases (65%): oesophageal disorders mainly gastroesophageal reflux were detected in 14 cases and concomitant oncological disease was found in 8. Only 3 cases were admitted for surgery due to these findings. Therapeutic strategies with metoclopramide were used in 18 subjects, chlorpromazine in 17 and baclofen in 13, while carbamazepine or haloperidol were used in a minority. Phrenic nerve stimulation was employed in 6 patients. Hiccups disappeared in 32 cases. Out of 22 cases for which follow-up was possible, the hiccups recurred in 5 subjects (the subjects requiring new therapies) and 11 patients died.
Conclusions: Chronic hiccup represents a multidisciplinary challenge that includes potential head and neck affection, a diagnostic schedule for ruling out causes, frequent base oesophageal alterations and high incidence of malignant neoplasm. Prokinetic and neuroleptic agents with antidopaminergic and anticholinergic effects are the pillars of its treatment. (C) 2016 Published by Elsevier Espana, S.L.U.
Filiaciones:
García Callejo FJ:
Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Valencia, España.
Redondo Martínez J:
Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Valencia, España
Pérez Carbonell T:
Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Valencia, España
:
Servicio de Otorrinolaringología, Hospital General de Requena, Requena, Valencia, España
Martínez Beneyto MP:
Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Valencia, España
Rincón Piedrahita I:
Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Valencia, España
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